Influence of aspect ratio, plasma viscosity, and radial position of the resonant surfaces on the plasmoid formation in the low resistivity plasma in Tokamak

In the present paper, we systematically investigate the nonlinear evolution of the resistive kink mode in the low resistivity plasma in Tokamak geometry. We find that the aspect ratio of the initial equilibrium can significantly influence the critical resistivity for plasmoid formation. With the aspect ratio of 3/1, the critical resistivity can be one magnitude larger than that in cylindrical geometry due to the strong mode-mode coupling. We also find that the critical resistivity for plasmoid formation decreases with increasing plasma viscosity in the moderately low resistivity regime. Due to the geometry of Tokamaks, the critical resistivity for plasmoid formation increases with the increasing radial location of the resonant surface.

Alterations of Selected Hemorheological and Metabolic Parameters Induced by Physical Activity in Untrained Men and Sportsmen

Optimal tissue oxygen supply is essential for proper athletic performance and endurance. It also depends on perfusion, so on hemorheological properties and microcirculation. Regular exercise is beneficial to the rheological status, depending on its type, intensity, and duration. We aimed to investigate macro and microrheological changes due to short, high-intensity exercise in professional athletes (soccer and ice hockey players) and untrained individuals. The exercise was performed on a treadmill ergometer during a spiroergometry examination. Blood samples were taken before and after exercise to analyze lactate concentration, hematological parameters, blood and plasma viscosity, and red blood cell (RBC) deformability and aggregation. Leukocyte, RBC and platelet counts, and blood viscosity increased with exercise, by the largest magnitude in the untrained group. RBC deformability slightly impaired after exercise, but showed better values in ice hockey versus soccer players. RBC aggregation increased with exercise, dominantly in ice hockey players. Lactate increased mostly in soccer players, and the respiratory exchange rate was the lowest in ice hockey players. Overall, short, high-intensity exercise altered macro and microrheological parameters, mostly in the untrained group. Significant differences were found between the two sports. The data can be useful in training status monitoring, selection, and in revealing the causes of physical loading symptoms.

The Clinical Efficacy of Ginkgo biloba Leaf Preparation on Ischemic Stroke: A Systematic Review and Meta-Analysis

Background. Ginkgo biloba leaf preparations (GLPs) are widely used in ischemic stroke, and uncertainty remains regarding their clinical efficacy. To evaluate systematically the clinical efficacy and safety of GLPs in the treatment of ischemic stroke, we examine evidence from randomized controlled trials (RCTs). Methods. We examine studies published prior to November 2021 that were found from searching the following sources: PubMed, China National Knowledge Infrastructure (CNKI), WANFANG DATA, Chongqing VIP (CQVIP) databases, and Chinese Biomedical Literature (CBM). We evaluated the quality of the included references according to the Cochrane Manual of Systematic Evaluation and Meta-analysis (MA) performed using RevMan 5.2 software. Results. We included a total of 13 RCTs with clinical therapeutic effects, the National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), hemorheology index, and adverse reaction index as evaluation criteria. There were 631 cases in the observation group and 629 cases in the control group. MA results showed the following: NIHSS WMD = −3.89, 95% CI: [−4.22, −3.56], I2 = 19%, P < 0.00001. This index is often used with nerve injury and can also be used to judge the recovery of nerve function. A lower score means less nerve damage and a better chance of recovery. The BI results were WMD = 11.30, 95% CI: [9.83, 12.77], I2 = 7%, P < 0.00001. This index was used to assess patients’ ability to take care of themselves, with a higher score indicating a stronger ability to live independently. Clinical effective rate results were WMD = 3.79, 95% CI: [2.49, 5.78], I2 = 0%, P < 0.00001, and this measure can be used to evaluate the effect of treatment clearly and objectively. Hemorheological index results show that plasma viscosity has WMD = −0.16, 95% CI: [−0.20, −0.12], I2 = 40%, P < 0.00001 and fibrinogen (FIB) has WMD = −1.13, 95% CI: [−1.23, −1.04], I2 = 0%, P < 0.00001. Plasma viscosity is mainly related to the amount of fibrinogen, and fibrinogen degradation is an important function of the fibrinolytic system. The imbalance of the fibrinolytic system plays an important role in the pathogenesis of cerebral infarction. Fibrinogen is a risk factor of ischemic cerebrovascular disease. Studies have shown that the infarct size of patients with secondary cerebral infarction after CEREBRAL infarction is correlated with their FIB level. In addition, FIB elevation is also one of the risk factors for early infarction after thrombolysis. Therefore, FIB can be used as a detection index for the prevention of cerebral infarction recurrence adverse reactions. Our MA results for FIB show WMD = 0.81, 95% CI: [0.38, 1.73], I2 = 0%, P = 0.58, and RR < 1. Conclusion. The existing clinical evidence shows that GLP has a good therapeutic effect on patients with ischemic stroke and can improve their hemorheology indices. In addition, GLP is shown to be relatively safe.

Safety of Five Tuina Manipulations in Rats with Deep Vein Thrombosis

Objective. To study the effects of five tuina manipulations in rats with deep vein thrombosis (DVT) and to explore how to safely perform tuina in the treatment of thrombotic diseases. Methods. Seventy-two male Sprague-Dawley (SD) rats were randomly divided into the model, pointing manipulation, plucking manipulation, kneading manipulation, pushing manipulation, and pulling manipulation groups (n = 12). DVT model was established by incomplete ligation. The tuina intervention was started on the next day after modeling and applied once a day 10 times by the manipulation simulators. On the 3rd and 10th days after intervention, respectively, the effects of tuina on thrombosis were evaluated based on thrombus elasticity, blood coagulation, fibrinolytic function and blood rheology with the ultrasound elastography, four coagulation tests, enzyme linked immunosorbent assay (ELISA), and hemorheology tests. Results. In the pointing manipulation group, the strain rate ratio, 6-ketoprostaglandin F1α (6-Keto-PGF1α), and high shear rate were decreased, and the thromboxane B2 (TXB2) content was increased ( P < 0.05 ). In the plucking manipulation group, the D-dimer and 6-Keto-PGF1α contents were increased, prothrombin time (PT) was shortened, and activated partial thromboplastin time (APTT) was activated, and the high shear rate and plasma viscosity were decreased ( P < 0.05 ). In the kneading manipulation group, APTT was shortened, and 6-Keto-PGF1α, high shear rate, and plasma viscosity were decreased ( P < 0.05 ). In the pushing manipulation group, the strain rate ratio, low shear rate, and high shear rate were all decreased ( P < 0.05 ). In the pulling manipulation group, both the strain rate ratio and the low shear rate were decreased ( P < 0.05 ). The 6-Keto-PGF1α changes on the 3rd and 10th days after intervention were opposite in the pushing manipulation group and the pulling manipulation group ( P < 0.05 ). Conclusion. The pointing, pushing, and pulling manipulations seem to be safe in the early period of thrombosis, but the risk is likely to be elevated as the treatment course of intervention increases. The plucking and kneading manipulations potentially have certain risks in the treatment of DVT in rats.

Hemorheological Parameters in Diabetic Patients: Role of Glucose Lowering Therapies

Diabetes mellitus influences several important hemorheological parameters including blood viscosity, erythrocyte aggregation and deformability. In the present study, 159 type-2 diabetic patients and 25 healthy controls were involved. Patient’s age, body weight, body mass index (BMI), smoking habits, physical activity, history of cardiovascular diseases, current antidiabetic therapy and concomitant medication were recorded. Patients were grouped according to their antidiabetic treatment with insulin, or with one or more of the following antidiabetic drugs: metformin, sulfonylureas, acarbose, or no antidiabetic therapy. Hemorheological measurements (hematocrit, erythrocyte aggregation, plasma fibrinogen, whole blood and plasma viscosity), von Willebrand factor activity, and platelet aggregation measurements were performed. Platelet aggregation was investigated with the method of Born. Plasma viscosity and red blood cell aggregation were significatly higher in diabetes. No significant difference was found in hemorheological parameters between different antidiabetic regimens. Whole blood and plasma viscosity and red blood cell aggregation correlated with glucose levels but not with HbA1C levels. In conclusion, plasma and whole blood viscosity, as well as red blood cell aggregation appear to be associated with concurrent hyperglycemia, but not with the quality of glycemic control or the applied antidiabetic treatment. Platelet aggregation induced by ADP or epinephrine does not seem to be associated with diabetes even at subthreshold doses.

IgM Paraprotein-Associated Type 1 Cryoglobulinaemia: Clinical Characteristics and Outcomes

Introduction Type 1 cryoglobulinaemia (CG) is characterised by monoclonal immunoglobulins which precipitate at temperatures below 37°C and redissolve on warming. They may be associated with lymphoproliferative disorders including Waldenström's macroglobulinemia (WM), other non-Hodgkin lymphoma (NHL), chronic lymphocytic leukaemia (CLL) or monoclonal gammopathy of undetermined significance (MGUS). Due to their rarity and heterogeneous clinical manifestations, incidence and outcomes are not well characterised and they are likely underdiagnosed. We retrospectively reviewed our cohort of patients (pts) with IgM paraprotein-associated type 1 CG. Methods Data from consecutive pts during 2013 and 2021, aged &gt;18 years were extracted from clinical databases at two specialist centres [UCLH, United Kingdom (UK) and AMC, Netherlands]. Results A total of 62 pts (38 male, 24 female) were identified (Table 1); 59 from UK and 4 from Netherlands: 49 (79%) had WM, 7 (11%) IgM MGUS and 6 (10%) NHL (5 other lymphoma, 1 CLL). Median age at CG diagnosis was 66 (range 39-90) years; 32 (52%) were &gt;65 years. MYD88 was mutated in 23/25 (92%) evaluable cases of WM. All cases were negative for hepatitis C. CG was detected after the monoclonal disorder in 46 (74%), with a median time to CG diagnosis of 8 (range 0-1390) months, concurrently in 11 (18%) pts and at a median of 1 month (range 0-4) in 5 (8%) pts prior to the monoclonal disorder. These patients were diagnosed due to CG symptoms. Eight pts (of which 50% had WM) also had active cold agglutinin disease (CAD). CG symptoms were present at time of testing in 25 (40%) pts; the others were diagnosed as a part of asymptomatic screening. CG symptoms were more common in those with MGUS / NHL compared to WM, most frequently in MGUS compared to WM (33% v 71%, p=0.05). Skin manifestations including acrocyanosis, purpura, ulcer and necrosis were noted in 14 (23%); 11 (18%) had peripheral neuropathy (6 sensory, 5 mixed) and 8 (13%) hyperviscosity. Median plasma viscosity was &gt;7 (range 4.7 - &gt;7) mPa of 5/8 pts measured with hyperviscosity and a median paraprotein of 29 (range 5-63) g/l. One patient with WM had cryoglobulinaemic glomerulopathy demonstrated by renal biopsy. In all, 53 (85%) pts received treatment, 10 (16%) for the CG and 43 for the monoclonal disorder, including plasma exchange (11/53). Thirty had Rituximab-based therapy (Table 1), and one received Ibrutinib. All achieved complete resolution of symptoms and 3/6 (50%) treated for CG had complete biochemical response with cryoglobulins undetectable after treatment. Two (20%) required further lines of therapy &gt;4 years later. Overall at a follow up of 21 (range 0-94) months, median survival was not reached. Nine (14%) pts died, with 1 (2%) CG-related death due to relapse disease. Estimated 5-year overall survival (OS) was 67% (95% CI 40-84%) (figure 1). Conclusions In our cohort of 62 pts with type I IgM paraprotein-associated CG, the majority had WM compared to other NHL and MGUS, likely reflecting the clinical bias of the centres and our policy of screening for CG at first visit. A greater proportion of cases (40%) were symptomatic than previous reports (16%; Néel et al, 2014); when present, symptoms were dominated by skin manifestations, neuropathy and hyperviscosity. Patients tested for CG with IgM MGUS were more likely to be symptomatic compared to WM. CAD co-existed in a proportion. Those with CG symptoms treated had good clinical responses; treatment subgroups were too small to draw conclusions as to relative efficacy, but Rituximab-based therapy appeared effective in most cases. CG-related mortality was low with an estimated 5-year OS 67%. Figure 1 Figure 1. Disclosures Vos: Sanofi: Membership on an entity's Board of Directors or advisory committees; Celgene: Other: Travel reimbursement. D'Sa: Janssen Cilag: Honoraria, Research Funding; BeiGene: Honoraria, Research Funding; Sanofi: Honoraria.

Clinical Effect Analysis of Acupuncture Combined with Cupping Exercise in The Treatment of Chronic Pelvic Inflammatory Disease

Objective: To explore the clinical efficacy of acupuncture combined with cupping exercise in the treatment of chronic pelvic inflammation. Methods: The subjects of this study were all patients with chronic pelvic inflammation who visited our hospital from November 2018 to November 2019, a total of 90 cases. The patients were divided into control group and research group according to the single and double numbers of the beds, 45 cases in each group. The patients in the control group were treated with conventional Western medicine, while the patients in the study group were treated with acupuncture and cupping exercise, and the clinical effects of the two treatment methods were compared. Results: The total effective rate was 95.56% in the study group and 84.44% in the control group, which was significantly higher in the study group than in the control group. The data between the two groups were statistically significant (P<0.05). The scores of menstrual disorder, abdominal distension, abnormal leucorrhea and lumbosacral pain in the two groups were significantly lower than those before treatment (P<0.05), and the corresponding scores of syndromes in the study group after treatment were (1.05+0.40), (0.73+0.38), (0.74+0.24) and (0.53+0.16), which were significantly lower than those in the control group (P<0.05). The plasma viscosity and hematocrit in both groups were significantly lower than those before treatment (P<0.05). The plasma viscosity and hematocrit in the study group after treatment were (1.14+0.32) mPa * s and (0.41+0.06) %, respectively, which were significantly lower than those in the control group (P<0.05). There was no significant difference in the levels of inflammatory factors between the two groups before treatment (P>0.05). The level of inflammatory factors in the study group after treatment was (5.74 + 2.35) mg/L, which was significantly lower than that in the control group after treatment, and the difference between tne groups was statistically significant (P < 0.05). Conclusion: Acupuncture combined with cupping exercise has a very significant clinical effect in the treatment of chronic pelvic inflammatory disease, can effectively improve the TCM syndrome score of patients, and improve the hemorheology and inflammation level of patients, so it can be widely used in clinical practice.

Dose–response relationship between urinary PAH metabolites and blood viscosity among coke oven workers: a cross-sectional study

ObjectivesPolycyclic aromatic hydrocarbons (PAHs) have been proven to be a risk factor for cardiovascular disease in coke oven workers, and increased plasma viscosity is a signal for higher risk of catching up cardiovascular disease. We want to explore whether the plasma viscosity is affected by the concentration of PAHs.DesignOur study is a cross-sectional dose–response study.SettingParticipants in this study came from a coke plant in Taiyuan, Shanxi.ParticipantsWe used data of 693 coke oven workers in Taiyuan.Primary and secondary outcome measuresWe assumed that plasma viscosity would increase as the concentration of PAHs metabolites in urine increases. We found that 2-hydroxyfluorene (OHFLU2) and plasma viscosity have a stable linear relationship in different statistical methods.ResultsWe found that plasma viscosity increased by 1.14 (mPa.s,30/s) for each ng/mL of 2-OHFLU urinary (correlation coefficient range: 0.54–1.74, p<0.05).ConclusionsThe results of this study could provide evidence for coke oven workers to prevent cardiovascular disease by checking whether plasma viscosity is elevated.

The effect of rheopheresis treatment on the cytokine profile in diabetic foot syndrome with hyperviscosity in the aspect of clinical changes: A preliminary study

BACKGROUND: Rheopheresis is a selective extracorporal double cascade filtration treatment, which can extract high molecular weight proteins being responsible for hyperviscosity. As the whole blood and plasma viscosity decrease microcirculation improves. OBJECTIVE: In this preliminary study we aimed to analyze additional beneficial effects of rheopheresis treatment with changes of pro-inflammantory cytokine levels in diabetic foot syndrome patients. METHODS: Two rheopheresis treatments were performed for 6 patients with diabetic foot ulcer and/or neuropathy on consecutive days. Before and after the treatments whole blood and plasma viscosity, as well as IL-6, IL-8, and TNF-alpha serum levels were determined, and complex angiological and ENG examinations were performed. RESULTS: Rheopheresis decreased the whole blood and plasma viscosity, and the serum levels of IL-6, IL-8, and TNF-alpha were markedly reduced. The life quality of the patients improved, the ulcers healed, the pain decreased. Daily dose of analgesics decreased in the follow-up period (6 months). The ENG showed improving amplitude and/or normalizing conduction speed. CONCLUSION: Application of rheopheresis in patients with diabetic foot syndrome has a beneficial effect, providing favorable rheological condition, normalizing cytokine profile and reducing the sensorineural symptoms.

Continuous Lumbar Plexus Block under the Guidance of the “Shamrock Method” Ultrasound: Analgesic Effects and Hemodynamic Effects after Total Knee Arthroplasty in Elderly Patients

Objective. To explore the effect of continuous lumbar plexus block guided by the “Shamrock method” on postoperative analgesia and hemodynamics in elderly patients after total knee arthroplasty (TKA). Methods. From January 2020 to December 2020 in our hospital, 98 patients who underwent TKA were selected. Using the random number table method, the patients were divided into two groups: a continuous lumbar plexus block group (group L), with 49 patients, and a continuous femoral nerve block group (group F), with 49 patients. The onset time and maintenance time of motor and sensory nerve blocks in patients were recorded. A visual analogue scale (VAS) was applied to assess the pain severity at 6, 12, 24, and 48 h after the operation. The VAS score (FVAS) was applied to evaluate the pain severity of the patients during 24 and 48 h after the operation and knee joint functional exercise. The levels of hemodynamic indexes such as heart rate, mean arterial pressure, and oxyhemoglobin saturation and the levels of hemorheological indexes such as plasma viscosity, high and low whole blood shear viscosity, fibrinogen, and hematocrit were detected and compared between the two groups immediately after the operation and at 12 h and 48 h after the operation, respectively. The incidence of adverse reactions induced by anesthesia was counted. Results. The onset time of motor and sensory nerve blocks in group L was lower than that in group F, and the maintenance time was higher than that in group F ( P < 0.05 ). The VAS scores of 6, 12, 24, and 48 h after operation in group L were significantly lower than those in group F ( P < 0.05 ). The FVAS scores of group L at 24 and 48 h after operation were significantly lower than those of group F ( P < 0.05 ). The heart rates of the patients in the two groups were higher at 12 h and 48 h after operation than those immediately after operation ( P < 0.05 ). The heart rates at 12 h and 48 h after operation in group L were lower than those in group F ( P < 0.05 ). The plasma viscosity, high whole blood shear viscosity, and low whole blood shear viscosity in the group L at 12 h and 48 h after operation were lower than those in group F ( P < 0.05 ). There was no significant difference in the incidence of local anesthetic poisoning, nausea, vomiting, urinary retention, pruritus, and other adverse reactions between the two groups ( P > 0.05 ). Conclusion. The “Shamrock method” ultrasound-guided continuous lumbar plexus block in elderly patients after TKA has good analgesic effect, stable hemodynamics, little influence on hemorheology, and good safety. It is of great value to enhance the surgical effect and promote postoperative rehabilitation.